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In his recent editorial [1], Dr. Prystowsky discusses the ACUTE (Assessment of Cardioversion Using Transesophageal Echocardiography) Pilot Study [2]. His dissatisfaction with the study seems to stem from the stated limitations of conventional management, which include the delay of direct-current cardioversion (DCC), the increased risk for bleeding, the inconvenience of readmission for DCC, the occurrence of strokes despite anticoagulation, and the lack of controlled studies showing efficacy [2]. Prystowsky defends the conventional approach and asks “If it ain't broke, why fix it” [1].